What is a Clinical Nurse Leader?

CNLs are highly skilled nursing professionals who have earned a master’s or post-master’s degree in a formal CNL education program.  In their daily job duties,  they are responsible for various roles and responsibilities within the hospital/healthcare setting. Read on to learn more about Clinical Nurse Leader roles and responsibilities.

Clinical Nurse Leader Roles and Responsibilities

CNLs have many roles and responsibilities, as they are constantly evaluating patient outcomes, assessing cohort risk, and making leadership decisions to change care plans when necessary. Other components of the job include patient and staff education, patient assessment, supervision of optimal protocols, and direct patient care when needed. CNLs are trained to work in all types of clinical settings, mostly in hospitals, but also in physician offices, urgent care centers, home health agencies, government and regulatory agencies, community health agencies, and higher education.

Fundamental Aspects of the CNL Role

The AACN first outlined the fundamental aspects of the CNL role in its White Paper on the Education and Role of the Clinical Nurse Leader. These defining aspects include the following:

  • Leadership in the care of the sick in and across all environments
  • Design and provision of health promotion and risk reduction services for diverse populations
  • Provision of evidence-based practice; population-appropriate healthcare to individuals, clinical groups, and communities
  • Clinical decision-making
  • Design and implementation of plans of care
  • Risk anticipation
  • Participation in identification and collection of care outcomes
  • Accountability for evaluation and improvement of point-of-care outcomes
  • Mass customization of care
  • Client and community advocacy
  • Education and information management
  • Delegation and oversight of care delivery and options
  • Team management and collaboration with other health professional team members
  • Development and leveraging of human, environmental and material resources
  • Management and use of client-care and information technology
  • Lateral integration of care for a specified group of patients

It is clear from this rather detailed list that the CNL role was designed for highly educated and trained individuals who can successfully handle a variety of roles and responsibilities, all designed to enhance patient outcomes. As a leader in the healthcare delivery system, CNLs assume accountability for patient outcomes, and they are providers and managers of care at the point of care, which means they have the unique ability to be both bedside nurses and leaders.

CNL as Leader/Team ManagerClinical Nurse Leader Roles and Responsibilities

One of the core roles of CNLs is leadership, both as an advocate for quality outcomes and as a member of a profession. In an article published in The Online Journal of Issues in Nursing titled “The Clinical Nurse Leader: Point-of-Care Safety Clinician,” authors Kathryn Reid and Pamela Dennison identify the CNL function of advocate as effecting change through advocacy for the profession, interdisciplinary team, and the client, as well as communicate effectively to achieve quality client outcomes and lateral integration of care for a cohort of clients. Functioning as members of a profession, CNLs must actively pursue new knowledge and skills as the CNL role, needs of the clients, and the healthcare system evolves.

In addition to the traditional Clinical Nurse Leader roles and responsibilities,  CNLs also serve as team managers who act as the bridge between numerous individuals and departments. The role of team manager is important for care coordination and represents a significant skill that is developed throughout the CNL educational process. As team managers, CNLs coordinate complex acute and chronic conditions and promote effective and timely communication among multiple healthcare providers, including physicians, nurses, therapists, and consultants. Care can often become fragmented for the patient and the family, but the CNL role helps ensure that patient and family needs are assessed and properly communicated with all members of the healthcare team.

Having CNLs act as patient advocates and care navigators has a positive effect on the psyche of patients and their families. In a recent article on Medscape (an online global destination for physicians and healthcare professionals), pediatric nurses Erin O’Grady and Brigit VanGraafeiland stress that the CNL managerial role provides congruency for the patient and a familiar face to the family. Simply being present throughout care, they say, allows the patient and family more time to ask questions and provides the family with a sense of commitment to the entirety of care.